Tubular forms of papova viruses in human laryngeal papilloma

Results of treatment with alpha-interferon in adult-onset laryngeal papillomatosis

Juvenile laryngeal papilloma occurs mainly in childhood, but is also occasionally seen in adults. The treatment of this disease has been very unsatisfactory. During the last decade, vaporization of the papillomas with the carbon dioxide laser has been the most frequently applied method of treatment, but recurrences are often observed. Alpha-interferon seems to affect the clinical course of juvenile laryngeal papillomatosis in children. We therefore started treating 3 patients with persistent adult-onset laryngeal papillomatosis with alpha-interferon in combination with regular endoscopic removal using the CO2 laser. In 1 case a complete remission occurred within 3 months. Administration of alpha-interferon was continued for another 6 months. Laryngoscopy in the 2 other patients showed only minor lesions after treatment with alpha-interferon for 1 1/2 years. Alpha-interferon treatment is still being continued. The dramatic improvement in the laryngeal picture of these patients during the treatment with alpha-interferon leads to the conclusion that alpha-interferon can affect the course of this disease. Whether a definite cure can be achieved is, however, still questionable.

Further observations on the treatment of recurrent respiratory papillomatosis with interferon: a comparison of sources

Between June 1982 and March 1983, 11 patients with aggressive recurrent respiratory papillomatosis were treated with alpha or human leukocyte interferon (IFN) that was produced by and purchased from the New York Blood Center, Inc. The year before, nine of these patients had been on a similar protocol utilizing alpha-IFN that had been supplied by the Finnish Red Cross Blood Transfusion Service. Comparisons regarding response and toxicity were made and are reported. In our series we have not seen an overall difference in response of papillomatosis to these two IFNs. As many of our patients responded better to the New York product as responded worse. There is a suggestion, however, that the New York product is associated with less toxicity than the Finnish IFN.

Adult recurrent multiple laryngeal papilloma: laser management and socioeconomic effects

Results of laser treatment of 15 adults with multiple recurrent laryngeal papilloma are reviewed. The pathology in all cases was benign and typical of juvenile recurrent papilloma. The laser is a precise tool in their therapy but is not curative. In 8 patients where complete remission has been achieved, the mean number of laser treatments was 5.3. The social and economic effects of papilloma and their treatment are discussed, from the standpoint of multiple hospitalization, threatened loss of employment, lack of promotion caused by poor voice, and handicap at home.

Leukocyte interferon in patients with juvenile laryngeal papillomatosis

Fourteen patients with aggressive juvenile papillomatosis were treated with systemic administration of alpha-type interferon (IFN). This initial dosage of 2 million units alpha-interferon/m2 was modified if a favorable response in the papilloma growth occurred, or if persistent drug-related side effects developed. Half of the patients showed a sustained response while on IFN, and two patients had a complete response. Persistent elevation in SGOT was the main dose-limiting toxicity, especially in infants below age seven years. All side effects subsided after the drug was discontinued. Further studies are recommended.